Prison of the Mind

by Austin Kuntz

One in four citizens in the United States (U.S.) suffer from a mental illness. Looking at that figure in raw numbers, this data translates to 62 million Americans. When looking specifically at those imprisoned in the U.S., the prevalence of mental illness is even greater. The last survey of mental health in prisons and jails across the country was conducted in 2006, when the Bureau of Justice Statistics found that 50 percent of prisoners suffer from a mental illness. This data includes inmates of both jails and prisons – the difference being the length of the sentence. Since shorter sentences are served mainly in county jails, the highest amount of mentally ill prisoners is found there. Even though national surveys of prison health care are conducted every year, the Department of Justice has failed to produce a comprehensive publication of mental health data for correctional facilities in the last decade. However, according to recent reports of individual prisons and jails, the numbers of inmates with mental illness has increased every year for the past ten years.

For every patient at a psychiatric hospital, a prison or jail holds 10 mentally ill prisoners. Prisons have come to house more mentally ill than psychiatric facilities in the U.S., causing some to label jails and prisons as the “new asylums.” Correctional facilities, though, are not prepared to effectively care for the staggering number of inmates with mental conditions flooding in. Furthermore, only half of American jails provide treatment for mental illness, which includes pharmaceutical services and therapy, within the facility.

Prisoners with a serious mental illness, such as schizophrenia, bipolar disorder, major depression and related conditions require additional monitoring of prisoners from prison staff.

A report published by the Treatment Advocacy Center in July 2016 found that less than half of large jails, which hold at least 250 inmates, hire professionals outside of law enforcement officers to meet the needs of prisoners with mental illness. For jails with less than 250 prisoners, the statistic dips below a third of jails and below a tenth for jails with under 50 inmates. In a majority of county jails, the jail staff is entirely responsible for the care of mentally ill prisoners, even though 25 percent of those jails do not provide any formal training to the staff on how to work with prisoners with mental illness. As a result, treatment for mental illness within the criminal justice system is limited, and it is often times only found in larger jails.

The issues behind mental illness in the criminal justice system are not limited solely to treatment options and availability; victimization of those with mental illness also plays a role in the poor state of care. Prisoners with mental illness are more likely to be victimized not only by the other inmates, but by staff members as well. For example, a mentally ill prisoner is three times more likely to experience sexual assault by other inmates, 1.6 times more likely to face physical violence and 1.2 times more likely to be subject to the use of force by staff members. Along with lack of treatment and care, this victimization prevents those suffering mental illness being able to properly cope with their mental condition. Consequently, prisoners with mental conditions are much more likely to violate prison rules, commit suicide or self-harm and spend much longer in prison than the average inmate.

Unfortunately, when jail terms end, former prisoners with mental illness do not escape hardship. In order to help them reintegrate into society, it is imperative to have a support system established after release, and for mentally ill prisoners, that support lies within psychiatric facilities. When that support is not readily available, these prisoners find themselves without a way to sustain themselves or even stuck back in the criminal justice system soon after release. Some prisons attempt to assist mentally ill prisoners with release planning programs, but a study conducted by the Minnesota Department of Corrections found that such programs do not have a significant impact on recidivism rates among prisoners with serious mental illness. Correctional facilities lack psychiatric resources, so it comes as no surprise that the few programs offered to assist mentally ill prisoners fail to help with recuperation.

Treating mental illness is complex even when the patient is provided with access to physicians, medication and therapy, thus treatment options become almost nonexistent in jail or prison. While stigma against mental illness keeps some from seeking treatment, the larger issue within the criminal justice system is the lack of treatment. The harsh conditions of imprisonment, especially due to stigma and victimization, only add to the struggles of their mental illness. A safer environment and increased access to mental health care are needed within the criminal justice systems, and in cases of serious mental illnesses, redirection to a proper psychiatric facility, as well. Prisons and jails may be termed correctional facilities, but for the mentally ill, correction is not possible with the limited resources provided.